One-step chemically vapor deposited hybrid 1T-MoS2/2H-MoS2 heterostructures towards methylene blue photodegradation

The photocatalytic degradation of methylene blue is a straightforward and cost-effective solution for water decontamination. Although many materials have been reported so far for this purpose, the proposed solutions inflicted high fabrication costs and low efficiencies. Here, we report on the synthesis of tetragonal (1T) and hexagonal (2H) mixed molybdenum disulfide (MoS2) heterostructures for an improved photocatalytic degradation efficiency by means of a single-step chemical vapor deposition (CVD) technique. We demonstrate that the 1T-MoS2/2H-MoS2 heterostructures exhibited a narrow bandgap ∼ 1.7 eV, and a very low reflectance (<5%) under visible-light, owing to their particular vertical micro-flower-like structure. We exfoliated the CVD-synthesised 1T-MoS2/2H-MoS2 films to assess their photodegradation properties towards the standard methylene blue dye. Our results showed that the photo-degradation rate-constant of the 1T-MoS2/2H-MoS2 heterostructures is much greater under UV excitation (i.e., 12.5 × 10-3 min-1) than under visible light illumination (i.e., 9.2 × 10-3 min-1). Our findings suggested that the intermixing of the conductive 1T-MoS2 with the semi-conducting 2H-MoS2 phases favors the photogeneration of electron-hole pairs. More importantly, it promotes a higher efficient charge transfer, which accelerates the methylene blue photodegradation process.

Survivin drives tumor-associated macrophage reprogramming: a novel mechanism with potential impact for obesity

PURPOSE

Recent studies point to adipose-derived stem cells (ASCs) as a link between obesity and cancer. We aimed to determine whether survivin, which is highly secreted by ASCs from subjects with obesity, might drive a pro-tumoral phenotype in macrophages.

METHODS

The effect of ASC conditioned medium on the macrophage phenotype was assessed by expression studies. Survivin intracellular localization and internalization were examined by subcellular fractionation and immunofluorescence, respectively. Loss- and gain-of-function studies were performed using adenoviral vectors, and gene expression patterns, migration and invasion capacities of cancer cells were examined. Heterotypic cultures of ASCs, macrophages and cancer cells were established to mimic the tumor microenvironment. Survivin-blocking experiments were used to determine the impact of survivin on both macrophages and cancer cells. Immunohistochemical analysis of survivin was performed in macrophages from ascitic fluids of cancer patients and healthy controls.

RESULTS

We found that obese-derived ASCs induced a phenotypic switch in macrophages characterized by the expression of both pro- and anti-inflammatory markers. Macrophages were found to internalize extracellular survivin, generating hybrid macrophages with a tumor-associated phenotype that included secretion of survivin. Exogenous expression of survivin in macrophages generated a similar phenotype and enhanced the malignant characteristics of cancer cells by a mechanism dependent on survivin phosphorylation at threonine 34. Survivin secreted by both ASCs from subjects with obesity and tumor-associated macrophages synergistically boosted the malignancy of cancer cells. Importantly, survivin was mainly detected in ascites-associated macrophages from patients with a malignant diagnosis.

CONCLUSION

Our data indicate that survivin may serve as a molecular link between obesity and cancer and as a novel marker for tumor-associated macrophages.

Detection of free-living amoebae in domestic cats with and without naturally-acquired keratitis

Pathogenic free-living amoebae, most notably Acanthamoeba spp., are important pathogens of the human cornea. The importance of infection with free-living amoebae in cats with keratitis is currently unclear. The aim of this study was to determine the frequency of amoeba detection in corneas of cats with naturally-acquired keratitis and in the ocular surface microflora of cats without ocular disease. Clinical ophthalmic and in vivo corneal confocal microscopic examinations were performed on 60 cats with keratitis. Corneal scrapings were analyzed by amoeba culture; cytological evaluation; and Acanthamoeba, Hartmannella, and Vahlkampfia PCR assays. Following ophthalmic examination, conjunctival specimens collected from 60 cats without clinically apparent ocular disease were analyzed similarly. In one cat with ulcerative keratitis, amoeba cysts and trophozoites were detected by in vivo corneal confocal microscopy; an Acanthamoeba sp. was isolated from corneal specimens and detected by Acanthamoeba PCR assay; and suppurative corneal inflammation was present cytologically. An Acanthamoeba sp. was isolated from conjunctival specimens from one cat without clinically apparent ocular disease, but with suppurative inflammation demonstrated cytologically. Both Acanthamoeba isolates belonged to the T4 genotype. Naegleria-like amoebae were isolated in samples from two cats with keratitis and seven cats without clinical ocular disease, but amoebae were not detected by the other assays in these samples. Amoeba detection by culture was significantly (P = 0.01) associated with cytologically diagnosed corneoconjunctival inflammation. This study identified naturally-acquired Acanthamoeba keratitis in cats. Detection of Naegleria-like amoebae in samples from cats with and without keratitis is of uncertain pathological significance.

[Multiple myeloma : an overview of advances in biology and treatment]

Multiple myeloma is the second most common hematological malignancy, characterized by an uncontrollable proliferation of clonal plasma cells. Although progresses in understanding its pathobiology and its treatment are made every day, it remains incurable. Since myeloma is more and more common, especially in the elderly, we would like to propose an overview of its pathobiology, diagnostic criteria and treatment «guidelines».

[Diagnosis of anemia associated with alcoholic cirrhosis]

We report here the case of a 62-year-old patient with Child-Pugh stage C ethylic cirrhosis associated with severe macrocytic anaemia, refractory to iterative transfusions and withdrawal. After a haemorrhagic, deficiency-related, or sideroblastic etiology was ruled out, haemolytic anaemia was suspected. A blood smear allowed diagnosis of haemolytic anaemia with acanthocytes. This offers the opportunity to discuss anaemia in patients with alcoholic cirrhosis, a frequent complication spanning a broad severity range and having the potential to be life-threatening. Its origin can be multifactorial : acute haemorrhage, dilution, haemolysis (here due to acanthocytosis), marrow insufficiency caused by direct alcohol toxicity, malnutrition, iron deficiency, vitamin B9 or B12 deficiency, chronic inflammation, splenic sequestration induced by portal hypertension...

Tyrosine kinase inhibition is an important factor for gene expression of CRTH2 in human eosinophils and lymphocytes: A novel mechanism for explaining eosinophils recruitment by the neuro-immune axis in allergic rhinitis

We recently shown a novel neuro-immune competition between vasoactive intestinal peptide (VIP) and PGD2 for CRTH2 receptor, and that genistein augmented VIP and PGD2-induced eosinophil chemotaxis. However, there are neither studies on the CRTH2 gene expression in allergic rhinitis (AR) nor in the effect of tyrosine kinase inhibitors in CRTH2 gene regulation. Our Objectives were to study the gene expression modulation of CRTH2 receptor in AR patients and the effect of tyrosine kinase inhibitors (TKIs) on CRTH2 gene modulation. Nasal provocation tests, ELISA, qRT-PCR, western blot, flow cytometry and chemotaxis assays in modified micro-Boyden chambers, were all used, to achieve our objectives. Herein we show that AR patients increased the amounts of VIP and PGD2 in their nasal secretions in the early phase reaction, however CRTH2 gene expression from leukocytes recovered in their nasal secretions was upregulated only during the late phase reaction. The TKIs; Genistein, Erbstatin and Herbimycin A, induced the gene expression of CRTH2 and increased the protein content of CRTH2 in both human lymphocytes and eosinophils. This was functional as PGD2/VIP-induced eosinophil chemotaxis was augmented by the TKIs and inhibited by pervanadate, the tyrosine phosphatase inhibitor. These results open channels for therapeutic modalities targeting CRTH2 molecules in AR.

Performances and mechanistic investigations of a triphosphine trioxide/ionic liquid system for rare earth extraction

A triphosphine trioxide (TPO)/ionic liquid (IL) system for rare earth extraction: application for permanent magnet recycling.

Helminths of grizzly bears (Ursus arctos) and American black bears (Ursus americanus) in Alberta and British Columbia, Canada

Between May 2011 and June 2013, we collected the carcasses and gastrointestinal tracts of 40 American black bears (Ursus americanus Pallas, 1780) and 13 grizzly bears (Ursus arctos L., 1758) from populations of Alberta and British Columbia, Canada. Specimens were examined for helminths, which were identified to the species level by applying an integrated morphological and molecular approach. Our goal was to investigate parasite biodiversity and infection parameters in the sampled grizzly and black bears. We found seven parasite taxa: Dirofilaria ursi Yamaguti, 1941, Baylisascaris transfuga (Rudolphi, 1819), Uncinaria rauschi Olsen, 1968, Uncinaria yukonensis (Wolfgang, 1956), Taenia arctos Haukisalmi, Lavikainen, Laaksonen and Meri, 2011, Diphyllobothrium dendriticum (Nitzsch, 1824), and Diphyllobothrium nihonkaiense Yamane, Kamo, Bylund and Wikgren, 1986. The statistical significance of infection prevalence, intensity, and abundance for each helminth species was assessed relative to host species, gender, age class, sampling season, and location. This is the first unequivocal report of the potentially zoonotic tapeworms D. dendriticum and D. nihonkaiense in North American bears. Furthermore, we provide insight into the biology and ecology of the nematodes B. transfuga, D. ursi, and species of Uncinaria Frölich, 1789, and enrich the information available on the recently described tapeworm T. arctos.

[Current management of marginal zone lymphomas]

Marginal zone lymphomas (MZL) encompass three sub-types: MALT (Mucosae Associated Lymphoid Tissue) MZL, nodal MZL and splenic MZL. Immunophenotyping is essential for accurate diagnosis. Helicobacter Pylori is frequently associated with gastric localizations and its eradication can be sufficient for cure. Treatment of nodal MZL is similar to that of follicular lymphoma. Eradication of hepatitis C virus, frequently associated with splenic MZL development, can be sufficient. Without HCV infection, splenectomy constitutes first line therapy. As other indolent lymphomas, disseminated MZL are incurable and treatment should be started only in symptomatic patients.

Very low energy electron microscopy of graphene flakes

Commercially available graphene samples are examined by Raman spectroscopy and very low energy scanning transmission electron microscopy. Limited lateral resolution of Raman spectroscopy may produce a Raman spectrum corresponding to a single graphene layer even for flakes that can be identified by very low energy electron microscopy as an aggregate of smaller flakes of various thicknesses. In addition to diagnostics of graphene samples at larger dimensions, their electron transmittance can also be measured at very low energies.

[Diffuse large B cell lymphoma: management in 2012]

Diffuse Large B Cells Lymphoma (DLBCL) is the most common non-Hodgkin lymphoma and comprises a large number of different entities with different clinico-pathological characteristics. The role of positron emission tomography is essential during the initial staging and post treatment assessment, and potentially at early- or mid-treatment evaluation of response. First line therapy comprises immuno-chemotherapy with rituximab and different cytotoxic agents that differ for components, dosages and frequency of administration taking worldwide-recognized pre-treatment prognostic variables into account. After relapse, peripheral blood stem cells transplantation remains the only chance of cure. This review attempts to summarize the current state of our knowledge by highlighting the leads pursued to further improve current therapeutic results.

Gastrointestinal parasites of coyotes (Canis latrans) in the metropolitan area of Calgary, Alberta, Canada

Disease ecology is a relevant but relatively unexplored subject of research in urban coyotes ( Canis latrans Say, 1823). In fact, this carnivore may play a role in the circulation of parasites that can have implications on the health of humans and domestic dogs, but can also be affected by pathogens transmitted from domestic reservoirs. To investigate the gastrointestinal parasites of urban coyotes in Calgary, Alberta, Canada, we analyzed 61 carcasses and 247 fecal samples collected within the metropolitan area, including city parks, in 2009–2010. We found nine parasite taxa: Toxascaris leonina (Linstow, 1902), Uncinaria stenocephala (Railliet, 1884), Ancylostoma caninum (Ercolani, 1859), Pterygodermatites affinis (Jägerskiöld, 1904), Trichuris vulpis (Froelich, 1789), Echinococcus multilocularis Leuckart, 1863, Taenia crassiceps (Zeder, 1800), genus Giardia Kunstler, 1882, and genus Cystoisospora Frenkel, 1977. Factors related to coyote ecology, habitat characteristics, and dog management likely influence the community of coyote parasites in an urban environment, and need to be taken into account to assess the actual role of this carnivore in the maintenance of parasites in the city landscape. Further research is needed to assess the current risk for transmission of potentially zoonotic parasites (e.g., E. multilocularis, T. crassiceps, Giardia sp.) among coyotes, dogs, and humans.

Depression in the elderly: study in a rural city in southern Catalonia

Depression and anxiety are the most common psychiatric diseases among the elderly, and frequently go without diagnosis and treatment. However, evidence regarding the prevalence of depression related to the diagnostic systems utilized and the sociocultural variations in the different communities investigated (rural-urban) is contradictory. This study aims to evaluate the prevalence of depression in a rural area in the south of Catalonia, analysing the different age groups, identifying the causal factors of depression and determining whether there are gender differences. The descriptive and quantitative study includes 157 women and 160 men. The qualitative study evaluates 14 men and 52 women diagnosed with depression. Our results indicate a high risk of depression in elderly participants of our small rural community. Widowers suffer more depression than widows and the loneliness, illness, and task of caregiver were predictive variables for depression in these elderly men. The loss of the ability to perform activities of daily living associated with ageing has a greater effect on depression disorders in men than in women.

[How I treat... Acute myeloid leukemia in older patients with good performance status]

This article describes the treatment of acute myeloid leukemia in older patients with good performance status, and then discusses briefly some future therapeutic perspectives.

Protein-induced satiety: effects and mechanisms of different proteins

Relatively high protein diets, i.e. diets that maintain the absolute number of grams of protein ingested as compared to before dieting, are a popular strategy for weight loss and weight maintenance. Research into multiple mechanisms regulating body weight has focused on the effects of different quantities and types of dietary protein. Satiety and energy expenditure are important in protein-enhanced weight loss and weight maintenance. Protein-induced satiety has been shown acutely, with single meals, with contents of 25% to 81% of energy from protein in general or from specific proteins, while subsequent energy intake reduction was significant. Protein-induced satiety has been shown with high protein ad libitum diets, lasting from 1 to 6 days, up to 6 months. Also significantly greater weight loss has been observed in comparison with control. Mechanisms explaining protein-induced satiety are nutrient-specific, and consist mainly of synchronization with elevated amino acid concentrations. Different proteins cause different nutrient related responses of (an)orexigenic hormones. Protein-induced satiety coincides with a relatively high GLP-1 release, stimulated by the carbohydrate content of the diet, PYY release, while ghrelin does not seem to be especially affected, and little information is available on CCK. Protein-induced satiety is related to protein-induced energy expenditure. Finally, protein-induced satiety appears to be of vital importance for weight loss and weight maintenance. With respect to possible adverse events, chronic ingestion of large amounts of sulphur-containing amino acids may have an indirect effect on blood pressure by induction of renal subtle structural damage, ultimately leading to loss of nephron mass, and a secondary increase in blood pressure. The established synergy between obesity and low nephron number on induction of high blood pressure and further decline of renal function identifies subjects with obesity, metabolic syndrome and diabetes mellitus II as particularly susceptible groups.

Prostaglandin E2 receptor distribution and function in the gastrointestinal tract

Prostaglandin E2 (PGE2) is one of the most important biologically active prostanoids found throughout the gastrointestinal tract. Despite the fact that PGE2 regulates many physiological functions of the gut including mucosal protection, gastrointestinal secretion and motility, it is implicated in the pathophysiology of inflammatory bowel diseases (IBD) and colorectal neoplasia. The varied biological functions exerted by PGE2 are through the pharmacologically distinct, G-protein coupled plasma membrane receptors termed EP receptors. Disruptions of various prostanoid receptor genes have helped in unravelling the physiological functions of these receptors. To date, all four subtypes of EP receptors have been individually knocked out in mice and various phenotypes have been reported for each subtype. Similarly, in vitro and in vivo studies using EP receptor agonists and antagonists have helped in uncoupling the diverse functions of PGE2 signalling involving distinct EP receptors in the gut. In this review, we will summarize and conceptualize the salient features of EP receptor subtypes, their regional functions in the gut and how expressions of EP receptors are altered during disease states.

Tailoring surface properties of biomedical polymers by implantation of Ar and He ions

Ion implantation at 25 and 100 keV has been used as a tool for the modification of the surface properties of two biomedical polymers. The modulation induced by the different energy dispersion mechanisms of Ar and He have allowed satisfactory modifications for both the activation of the surfaces of chemically functional polycaprolactone (PCL) and the stabilization of anti-fouling poly(ethylene glycol) (PEG). In both cases the implantations have been performed at doses of 10(14) cm(-2) by taking into account the effect of different current densities, which are shown to distinctly influence the fragmentation-crosslinking of the target polymers. The resultant films were characterized by Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, time of flight secondary ion mass spectroscopy and atomic force microscopy. Both shifts in zeta potential versus pH curves and the alteration of the polar components of the surface free energy (contact angle measurements) were correlated with the composition analysis. The response of the modified surfaces towards biomolecular interaction is demonstrated by the induction of preferential adsorption on irradiated PCL and the inhibited adsorption onto implanted PEG regions for selected oligopeptides and proteins.

CD26, adenosine deaminase, and adenosine receptors mediate costimulatory signals in the immunological synapse

Adenosine deaminase (ADA), a protein whose deficit leads to severe combined immunodeficiency, binds to the cell surface by means of either CD26, A(1) adenosine receptors, or A(2B) adenosine receptors. The physiological role of these interactions is not well understood. Our results show that by a 3-fold reduction in the EC(50) for the antigen, ADA potentiated T cell proliferation in autologous cocultures with antigen-pulsed immature or mature dendritic cells. Costimulation was not due to the enzymatic activity but to the interaction of ADA-CD26 complexes in T cells with an ADA-anchoring protein in dendritic cells. From colocalization studies, it is deduced that ADA colocalizing with adenosine receptors on dendritic cells interact with CD26 expressed on lymphocytes. This costimulatory signal in the immunological synapse leads to a marked increase (3- to 34-fold) in the production of the T helper 1 and proimmflamatory cytokines IFN-gamma, TNF-alpha, and IL-6.

Le mouvement de la colonne scoliotique à l’âge adulte

OBJECTIVE

To describe the movement of the trunk in adults with untreated adolescent idiopathic scoliosis (AIS) and to evaluate their relationship with the age of the patients, the location and angle of the curve, and the number of involved intervertebral segments.

MATERIALS AND METHODS

Two hundred adult subjects with untreated AIS, without associated signs, were analyzed with rachimetry. The flexion, extension, bending, and rotation of the trunk were determined for each patient. The results were compared with a different sample: healthy subjects without spinal disease/other groups with more severe scoliosis (treated).

RESULTS

In the absence of discopathy, regardless of the angle, location of the curve, or age of the patient, adults with untreated AIS demonstrated a 24% increase in truncal flexion, and a 30% decrease in hip flexion. The other movements studied with rachimetry were comparable to normal subjects. Lesions of the intervertebral segments increased in number and severity with age. These lesions progressively limited the mobility of the spine, initially in extension; and then in bending and flexion.

CONCLUSIONS

The measurement of the mobility of the spine and the pelvis is part of the systematic examination of patients with adult scoliosis. This information can be used to improve the patients' health and spinal function; independent of their age and degree of spinal deformity.

Cigarette smoking and attention: processing speed or specific effects?

RATIONALE

It has been evidenced that nicotine acts on some dimensions of human attention.

OBJECTIVE

This study was carried out to test whether the positive effects of nicotine usually observed on the posterior system are specific or should rather be explained in terms of an effect of nicotine on eye movement velocity.

METHODS

Ten participants were submitted to four tasks assessing attention. The tasks were borrowed from Zimmermann and Fimm's Battery for the Assessment of Attention: alert, eye movements, visual search and incompatibility. The order of the different tasks was balanced among participants. A within-subjects repeated-measure design was used. Participants received a 0.9-mg or 0.1-mg nicotine cigarette. The 0.1-mg cigarette was used as control. The order of administration of doses over sessions was counterbalanced. During the testing day, volunteers smoked their own cigarette and then waited 3 h without smoking. At the end of this abstinence period, participants completed the baseline tests before smoking an experimental cigarette ad libitum. They were then tested again.

RESULTS

Participants who received nicotine appeared to respond faster in an eye movement task--a task associated with a non-elaborated attentional process. Similarly, their alert state improved. On the contrary, no effect of nicotine was observed in the incompatibility task and in the visual search task depending on elaborated attentional process.

CONCLUSIONS

Data support previous observations and suggest that, first, non-elaborated information processing appeared to be more sensitive to nicotine and, second, this effect is not due to a velocity factor.

Adherence over 48 Weeks in An Antiretroviral Clinical Trial: Variable within Patients, Affected by Toxicities and Independently Predictive of Virological Response

Objectives

To investigate adherence to antiretroviral therapy over 48 weeks, to investigate the association between adherence and treatment-related symptoms and to investigate the impact of adherence on virological response over 48 weeks among established predictors of treatment success.

Methods

One-hundred-and-sixty HIV-1 infected protease inhibitor- and stavudine-naive patients participating in a trial of ritonavir/saquinavir versus ritonavir/saquinavir/ stavudine completed an adherence questionnaire and a symptom checklist at weeks 12, 24, 36 and 48. We calculated odds ratios between experienced symptoms and non-adherence. Regression models were used to determine predictors of HIV-1 RNA below 400 copies/ml at week 48, and of the area about the change from baseline over 48 weeks (ACFB) in serum HIV-1 RNA.

Results

The percentage of patients reporting missing medication, deviation from time schedule, and dietary prescriptions at separate time-points ranged from 12 to 15%, 32 to 35% and 17 to 22%, respectively. The percentage that changed their level of adherence during 48 weeks ranged from 29% for skipping medication to 48% for deviation from time-schedule. Experienced side-effects were associated with an increased likelihood of non-adherence. Not skipping medication was an independent predictor of both having a serum HIV-1 RNA below 400 copies/ml at week 48 and the ACFB over 48 weeks in serum HIV-1 RNA.

Conclusions

Adherence was an independent predictor of virological response over 48 weeks. The level of adherence is variable within patients over time. This suggests the need for continued adherence monitoring in all patients as part of standard medical practice.

[Iodine 131 uptake by a bronchogenic cyst in a patient with differentiated carcinoma of the thyroid gland]

BACKGROUND

After thyroidectomy for differentiated thyroid carcinoma, extracervical uptake of iodine 131 is suggestive of metastasic dissemination. False positives can however occur.

CASE REPORT

Differentiated thyroid carcinoma was found in a female patient with a non-functional nodule. Two years after subtotal thyroidectomy and an ablative dose of iodine 131, the whole body scan showed abdominal mediastinal uptake with low serum thyroglobulin level. Considering the possibility of tumor recurrence or lymph node metastasis, the mass was excised. The histology diagnosis was mediastinal bronchogenic cyst.

DISCUSSION

To date, iodine uptake in a bronchogenic cyst has not been reported among other false-positives previously described. The pathophysiology of this iodine 131 uptake in a bronchogenic cyst is still unknown: the presence of NIS symporter or a protein which can organify iodine in the mucus cells of the cyst remains to be proven.

Defective functional activity and accelerated apoptosis in neutrophils from children with cancer are differentially corrected by granulocyte and granulocyte-macrophage colony stimulating factors in vitro

We have previously shown that polymorphonuclear leucocytes (PMN) harvested from children with cancer and exposed to chemotherapy exhibit defective bactericidal activities against both Gram-positive and Gram-negative microorganisms as well as accelerated apoptosis. In this study, PMN from children with cancer were evaluated to compare in vitro the corrective effects of the two myeloid colony stimulating factors G-CSF and GM-CSF on these defective pathways. Both G-CSF and GM-CSF were able to increase the defective bactericidal activities against S. aureus and E. coli. However, GM-CSF was consistently superior to G-CSF in correcting PMN microbicidal activity; this correction was incomplete since it did not reach the level observed in normal PMN exposed to GM-CSF. The accelerated apoptosis of PMN was not affected by G-CSF. In contrast, GM-CSF significantly prolonged the survival of the PMN although it did not reach the level of survival observed with normal PMN exposed to GM-CSF. These observations were consistent with other studies indicating that in PMN, microbicidal activities and apoptosis are differentially sensitive to the myeloid growth factors G-CSF and GM-CSF.

Ferritin-associated iron induces neutrophil dysfunction in hemosiderosis

Neutrophils (PMNs) from patients with secondary iron overload have an increased iron and ferritin content as well as a phagocytosis defect. Several serum components might be incriminated in the cellular iron accumulation. We therefore compared the effects on the PMN phagocytosis of total serum as well as the ferritin and transferrin fractions of serum derived from patients with thalassemia major and healthy control subjects. An incubation system of PMNs was developed. PMN phagocytosis was measured before and after incubation. Total serum from patients with thalassemia induced a defect that was prevented by co-incubation with deferoxamine (DFO). Gel-filtration chromatography was performed to separate the serum fraction containing transferrin and albumin from that containing ferritin. The transferrin-albumin fraction had no effect on PMN phagocytosis. On the contrary, the ferritin fraction of normal serum was deleterious to PMN phagocytosis, and the same fraction from thalassemic serum decreased PMN phagocytosis even more. Co-incubation with DFO or catalase improved this defect. Moreover, a cellular increase in the L-type subunit of ferritin was observed after the incubation of PMNs with the ferritin-containing fraction from thalassemic serum. In conclusion, serum from patients with thalassemia is toxic to PMNs, and this toxicity is due to ferritin-associated iron.

Prolonged but reversible neutrophil dysfunctions differentially sensitive to granulocyte colony-stimulating factor in children with acute lymphoblastic leukaemia

Treatment of average-risk acute lymphoblastic leukaemia (ALL) in children consists of 6 months of intensive chemotherapy followed by 18 months of maintenance therapy. Polymorphonuclear leucocyte (PMN) functions from children with ALL were studied in order to evaluate and compare the toxicity of the initial intensive treatment with the toxicity of the subsequent less intensive maintenance treatment. H2O2 and O2- production, evaluated by chemiluminescence, were significantly decreased during the intensive period but returned to normal values when maintenance therapy began. In contrast, bactericidal activity against Gram-positive and Gram-negative microorganisms remained at low levels throughout the treatment but returned to normal values in patients off chemotherapy. PMN from patients on maintenance therapy exhibited an excess of morphological changes associated with apoptosis. This was confirmed by standard two-colour flow cytometry which revealed an increase in the number of hypodiploid cells, and increased expression of membrane phosphatidylserine together with a drastic reduction in the expression of the Fcgamma receptor IIIB (CD16). These defective PMN were differentially sensitive to the effects of granulocyte colony stimulating factor (G-CSF): G-CSF induced similar increase in chemiluminescence in control and patient PMN; GSF partially corrected the defective bactericidal activity; G-CSF did not affect the accelerated PMN apoptosis. These observations indicate that ALL children undergoing chemotherapy present PMN defective functions which are partially sensitive or even resistant to G-CSF.

Case study of quality assurance in the administration of chemotherapy

The purpose of the study was to monitor the quality of chemotherapy administration within the department of oncology, of the university hospitals in Leuven (Belgium), by focusing on prescription and documented administration of chemotherapy. First, the actors and phases of the process were identified. Then selected patient records of three different types of chemotherapy were retrospectively analysed for 453 chemotherapy administrations. Study results indicated an important need to standardize the nursing and medical guidelines concerning chemotherapy administration. A formal task force was established to work on a multidisciplinary basis. The goals were to improve the routine process by identifying practical problems at any level and to standardize procedures by replacing all poorly defined "habits" by well-structured guidelines.

Defective polymorphonuclear leukocyte functions in children receiving chemotherapy for cancer are partially restored by recombinant human granulocyte colony-stimulating factor in vitro

Granulocyte colony-stimulating factor (G-CSF) has important direct and priming effects on different functions of normal mature polymorphonuclear leukocytes (PMNL). Previous study has shown an alteration in respiratory burst and bactericidal activities of PMNL harvested from children with cancer treated with chemotherapy. The present study evaluates the possibility that recombinant human (rh) G-CSF could correct these defective functions in vitro. Free radical formation in defective PMNL was enhanced by rhG-CSF to a level similar to that found in normal PMNL primed by rhG-CSF. The defective bactericidal activity against Escherichia coli and Staphylococcus aureus was also corrected. This bactericidal activity was not different from that observed in normal PMNL primed by rhG-CSF. In conclusion, correction of the altered free radical-formation pathway by rhG-CSF in these cells contributed to the restoration of normal bactericidal activity against both gram-positive and gram-negative microorganisms.

Granulocyte functions in children with cancer are differentially sensitive to the toxic effect of chemotherapy

To analyze the toxicity associated to chemotherapy upon granulocytes, different functional assays were performed, within days of drug exposure and at time of bone marrow recovery, on polymorphonuclear neutrophils (PMN) from children with cancer. There were no significant postchemotherapy changes in the expression of the different receptors studied nor in the phagocytosis of Staphylococcus aureus 42D. By contrast, a significant decrease was observed in H2O2 production in PMN recently exposed to chemotherapy with both cytofluorometric and chemiluminescence assays. There was also a decrease in the production of O2- and in chemotaxis; finally, the intracellular killing of S. aureus 42D and Escherichia coli was reduced. In patients having recovered from drug-induced bone marrow aplasia, PMN functions were found to be normal except for bactericidal activity which was still defective. The observations indicate that, in patients exposed to chemotherapy, some PMN functions are transiently altered, whereas microorganism cell killing is continuously impaired.

Role of nurses in cancer chemotherapy administration. Retrospective record analysis to improve role performance

The purpose of this quality assurance project in the University Hospitals in Leuven, Belgium, was to describe, analyse and improve the actual routine practice of chemotherapy administration. The article focuses on analysis and improvement of role performance of nurses. The process of chemotherapy was systematically assessed by means of a retrospective analysis of patient records. This was done for 61 patient records receiving 453 chemotherapy administrations. Five aspects of the role of oncology nurses were described and analysed: data collection for prescription of chemotherapy, communication of instructions, preparation of the cytotoxic treatment, administration of cytotoxics and post-chemotherapy assessment. Data analysis showed variability in relation to several role aspects. Standardization of procedures and information was introduced to improve role performance in several areas.

Mental rehearsal in table tennis performance

Effects of mental rehearsal were assessed on two measures of table tennis performance, counterattack forehand and counterattack backhand. Mental rehearsal combined with observational and physical techniques (N = 40) appeared to improve table tennis performance both qualitatively and quantitatively. Correlations suggested mental training effects cannot be explained only in terms of visual imagery.

[An epidemiologic survey of caries frequency and periodontal status in children 6 to 15 years of age in 11 provincial regions in central France, Bourgogne and the Ile de France]

An epidemiological survey of dental caries and periodontal conditions was conducted on 2,022 children in eleven french "departments" of Center of France and part of Bourgogne and lle de France. It showed a dft of 3.03 and dfs of 4.83 at the age of 6 years, as well as an increasing DMFT from 0.65 at the age of 6 to 7.26 at the age of 15. The DMFS increased from 0.91 at 6 years to 12.31 at the age of 15. The calculus index increased steadily from 0.14 at the age of 6 to 0.64 at the age of 15. The gingival index increased from 0.27 in the 6 year old, to 0.55 in the 15 year old.

Continuous subcutaneous insulin infusion in the treatment of juvenile-onset diabetes

Control of glycemia by means of continuous subcutaneous insulin infusion (CSII) was examined in two groups of diabetic patients. In the first group of five totally insulin-dependent diabetics, the glycemic profile was compared in hospital during optimized conventional insulin therapy and CSII. A second group of five recently diagnosed diabetic patients was treated for periods up to 70 days with CSII. Two insulin infusion systems were used: (1) a commercially available infusion pump and (2) a specially developed device, permitting a more flexible infusion rate and including an audible warning of malfunction. In the first group the mean plasma glucose levels decreased significantly under CSII (202 +/- 18 mg/dl vs 151 +/- 18 mg/dl; p less than 0.05; mean +/- SEM) although the M value and the MAGE index were similar during CSII and the optimized conventional therapy. In the second group of subjects, improved diabetic control, as assessed by the mean blood glucose level (135 +/- 18 mg/dl), and M value and the MAGE index, was rapidly achieved by CSII in all patients. Insulin requirements fell to zero in two of the three patients who maintained CSII at home for 60 and 70 days. It is concluded that CSII permits blood glucose control at least as good as optimized conventional treatment in totally insulin-dependent diabetics in hospital as well as in newly diagnosed diabetics.

[Treatment of insulin-dependent diabetes by continuous subcutaneous infusion of insulin (author's transl)]

Blood glucose levels were measured in 2 groups of patients with insulin-dependent diabetes during continuous subcutaneous infusion of insulin. Results demonstrated that continuous insulin infusion in totally insulin-dependent patients provides control of the diabetes comparable to that obtained by conventional optimized insulin therapy. Furthermore, the good control of blood glucose levels following infusion may permit remission in patients in whom the diabetes is of recent onset.

[National Research Program 1: participation in the base examination, analysis by means of a logit-linear model]

In each of four swiss cities participation to baseline screening for the prevention of cardio-vascular diseases is analyzed within a stratified random sample using a logit-linear model. Stratification was chosen along sex, age and time of residence for persons living alone, and mean age of parents, number of children and time of residence for persons living as a family.

[Vulvar granuloma due to Enterobius vermicularis (author's transl)]

The authors report a case of casual discovery of a enterobiasic vulvar granuloma arising on the left labia. This woman, living in Lille (France), 70 years had been treated by surgery and roentgentherapy for a well differentiated squamous carcinoma of the vulva. They consider the question of the genital localisation of Enterobius vermicularis in women and discuss the pathogenic hypothesis.